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CARDIAC REHABILITATION REDUCES DEPRESSION AND IMPROVES QUALITY OF LIFE IN MEN AND WOMEN

Abstract

CARDIAC REHABILITATION REDUCES DEPRESSION AND IMPROVES QUALITY OF LIFE IN MEN AND WOMEN

A.N. Green1, M. McNamara2, C. Oser2, C.A. Vella FACSM1.

1University of Idaho, Moscow, ID, 2Cardiovascular Health Program, Montana Department of Public Health & Human Services, Helena, MT

Research suggests participation in cardiac rehabilitation (CR) improves physical and mental health outcomes. Women entering CR have been shown to have higher incidences of depression compared with men. This may affect health outcomes and adherence to CR. Few studies have investigated the benefits of CR in women and even less have compared gender differences. PURPOSE: To investigate gender differences in depression and quality of life (QOL) pre and post CR. METHODS: Participants included (mean±SD) 10,721 men 65.4±11.2 y and 4,589 women 67.1±11.7 y from programs participating in the Montana Outcomes Project. Participants completed the Patient Health Questionnaire-9 (PHQ-9) to assess depression (5900 men and 2455 women) and the Short Form Health Survey (SF-36) to assess quality of life (QOL) (1007 men and 419 women). Statistical analysis included a chi-square test with an alpha value of ≤0.05 indicating significance. RESULTS: Top diagnoses for men and women were coronary artery bypass graft (28 and 18%), percutaneous transluminal intervention (PCI) (26 and 29%) and myocardial infarction with PCI (22 and 20%). The average number of cardiac rehabilitation visits was 21.5 ± 11.9 (mean±SE) for men and 20.9 ± 12.1 (mean±SE) for women. Prior to CR, a lower percentage of women reported minimal depression (57% vs. 49%; p<0.001) on the PHQ-9, but had higher reported percentages of mild-to-moderate depression (45% vs. 38%; p<0.001). There was no gender difference (6%) in prevalence of severe depression (p>0.05). Men had higher QOL scores prior to CR compared with women (physical score: 39.4 vs. 34.5 and mental score: 48.4 vs. 46.3; p<0.001). Post CR, while the prevalence of mild-to-moderate depression decreased in both men and women, gender differences remained for both the physical score (47.7 for men vs. 45.6 for women; p<0.001) and mental score (53.4 for men vs. 52.3 for women; p<0.05). CONCLUSIONS: Our findings suggest there are gender differences in QOL and depression in CR patients, with women appearing to suffer more from depression and lower QOL before and after CR. Our findings also suggest that depression level at the onset of CR does not affect adherence to CR and that despite higher levels of mild-to-moderate depression, women benefit from CR similarly to men.

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